Pharmacokinetics and pharmacodynamics are an essential part of understanding drug efficacy. Meanwhile, pharmacokinetics deals with the study of the effect of a drug on the body through absorption, distribution, metabolism and excretion. pharmacodynamics addresses how the drug affects the body. The objective of pharmacokinetics is to improve medication efficacy and decrease drug toxicity while benefiting from the therapeutic results. Due to the correlation of the concentration of the drug in the body and the effect of the medication on the body, prescribers are called upon to monitor the usefulness of the medication. This has therefore, make pharmacokinetics and pharmacodynamics very important in medicine (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). In order to understand the effect of drug pharmacokinetics and pharmacodynamics in patients this discussion focuses on explaining how this disease influences the effect of drugs on the body.
Patient is 16year old morbidly obese Native American female with a history of uncontrolled diabetes type II and depression. She came with her mom to the pediatric clinic because she was presented with lower abdominal pain for one week. In the evaluation process, the urine laboratory showed high levels of protein in the urine. Patient was admitted to the pediatric unit for treatment.
If the patient’s condition is observed, diabetes is a major contributing factor to her problem. In addition, the fact that she is in renal failure, which makes the treatment problematic, needs the doctor to consider the doses of medication. Following the pharmacokinetic and pharmacodynamic function, diabetes must be closely monitored. The pharmacokinetics of drugs are affected by the body’s ability to absorb, distribute, metabolize and eliminate the drug from the system. Diabetes is also a condition that damages the body’s ability to carry out its normal functions. The prescription of medications for this patient has a lot to do with her diabetic disease process that may be the cause of kidney disease. Prescribers will have to carefully consider the effect of the disease on the drugs reaching their therapeutic level, as well as the elimination process. The half-life of drugs will be an essential tool for prescribing.
Effect of absorption : increase in extracellular glucose affects membrane permeability and drug bioavailability.
Effect of distribution : The binding and affinity of albumin is impaired, due to the presence of high levels of glucose that glycate along with hemoglobin. The presence of free fatty acids also decreases the binding capacity of albumin.
Effect of metabolism : Most drugs are metabolized in the liver, but in the diabetic Mellitus condition, there is a decrease in CYP 3A4.
Effect on excretion : an increased rate of glomerular infiltration is observed in patients with diabetes mellitus. Microvascular and macrovascular changes are observed in patients with uncontrolled diabetes.
These medications, such as metformin, decrease hepatic glucose production, decrease intestinal glucose production, and increase peripheral glucose production and utilization.
Regular examinations for cardiovascular disease, liver function tests, evaluation of the kidneys should be carried out by the patient.
To conclude, the fact that diabetes patients turn to take more medication than nondiabetic patient, understanding the pharmacokinetics and pharmacodynamics of their medication will help providers prescribe safe medication to their patient (Dostalek, Akhlaghi, & Puzanovova, 2012).
Amir Houshang, M. V. (2015). Effect of diabetes mellitus on the metabolism of drugs and toxins. Journal of Clinical Toxicology, 05(02). doi:10.4172/2161-0495.1000233
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